Doctors, Health Workers At Daggers Drawn Over Pay Parity

Abuja The end may not be in sight in the rift between doctors and other health workers as the lingering crisis that has bedevilled the health sector over pay parity seems set to drag on. On its part, however, the Nigeria Medical Association (NMA) has warned against comparing and equating medical doctors with other health workers, insisting that they are not equal. The NMA president, Prof. Mike Ogirima, who sounded the warning while fielding questions exclusively from LEADERSHIP Sunday, stated that although health workers face hazards in the discharge of their duties, their output could not be compared to doctors who perform the bulk of the medical services.

Prof Ogirima, who was reacting to the 21-day ultimatum issued to the federal government by health workers to meet their demands or face industrial action, insisted that the association was not against moves to enhance the welfare of other health workers, but insisted that relativity should be maintained. He explained that medical doctors are highly skilled and few in the country, noting that the cut-off mark for medical students now is 280 and above. “Everybody wants to accept that title of doctor in the medical set up; we are not against that,” he said. “What we are against is the fact that everybody cannot be equated to be equal. In the animal kingdom, all animals are equal, but some are more equal than others.”

The NMA president stressed the need for government to evaluate different professionals in the health sector and audit their output, adding that doing so would provide more objective data and statistics to buttress their point. Prof Ogirima, however, advised aggrieved health workers to emulate NMA’s diplomatic approach to the issue of emoluments rather than resort to incessant strikes at the least grievance. “We do not believe in incessant strikes but mediate whenever crisis is perceived,” he said, adding that NMA was not part of the strike threat. “The ultimatum was not given by doctors, but whatever their grievances are, I think dialogue and proactive diplomacy shuttle should resolve most of their grievances. “I have never declared a national strike, and I am leaving the office, so that should be a plus for government. NMA does not believe in ceaseless strikes; what we do is go proactive and mediate to halt crisis.” Prof. Ogirima further advised that irrespective of the health workers’ agitation, they should consider the wellbeing of patients whom they are called to serve.

“The patient is central to our call and if you don’t have a divine call to work in the hospital, this is the best time to leave this noble profession. If you fail to acknowledge that patients are central and should be first to all your agitations, then take a bow and disappear from the hospital environment,” he stated. The NMA president blamed the situation on what he described as unworthy rivalry in the health sector and revealed that a recent study by an international expert in the health sector has vindicated doctors’ position, describing them as supreme. “What we have in the hospital is rivalry between professionals; it is uncalled for. If government has instituted job description for professionals in the hospital by training, admission criteria and by qualification, then the doctor is far ahead of others.” He said all over the world, it takes doctors 292 weeks to get the basic medical certificate, as against the 272 weeks it takes to obtain a Ph.D.

This, therefore, justifies the doctor’s take home pay package. He explained that “if government is increasing across board salaries or allowances of all health workers, there is usually relativity. From colonial system up until the Udorgi era, if doctors are paid N1.5 million for example, other bachelor’s degree holders receive N1.3million, then those with diploma or certificate get N1million.” “That relativity is what other health workers want to bridge; they want to erase it. We have told the government that we are not against salary increase for any health workers but that relativity must be maintained because doctors have been cheated for long.” Speaking on the effects of incessant strikes, the president lamented that in a country where the entire system is collapsing, causing more crisis by withdrawing services will obviously have a negative effect on the economy Health workers, including pharmacists, nurses and medical laboratory scientists had, in a communiqué issued at the end of a three-day consultative meeting, which ended on February 8, 2018, in Abuja, decried what they described as delay tactics and deliberate foot-dragging of the federal government in approving the adjustment of Consolidated Health Salary Scale (CONHESS) as was done for medical doctors’

Consolidated Medical Salary Scale (CONMESS) since January 2014. LEADERSHIP Sunday recalls that aggrieved health personnel, under the aegis of Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHP), had on September 29, 2017 suspended a 10-day-old strike after a meeting with the minister of Labour and Employment, Dr. Chris Ngige. A pharmacist with the Maitama General Hospital, Abuja, who gave his name as Magaji Yusuf, acknowledged that the sector is polarised and that there is mistrust and disharmony, even as he accused government of allowing double standards.

Yusuf said, “There is so much misinformation, impunity, violation of established rules and codes of conduct said the government has allowed itself to become a pawn in the hands of Nigerian Medical Association (NMA) and Medical and Dental Consultants Association (MDCAN) which are not legally recognised trade unions. He expressed shock that rather than wake up to its challenge, “the same government that was able to restrain a registered trade union from going on strike has not stopped an unregistered body posturing as a trade union.” The pharmacist wondered why the government has allowed the Constitution of the Federal Republic to be violated by NMA, which he accused of subjugating other workers in the health sector.

A female nurse at the Asokoro hospital who preferred anonymity told LEADERSHIP Sunday that under the then president, Alhaji Umaru Musa Yar’Adua, the Nigerian government in 2009 approved two different salary structures in the health sector known as Consolidated Medical Salary Scale (CONMESS) and Consolidated Health Salary Scale (CONHESS). She explained that while medical doctors in the service of the Nigerian civil service are on CONMESS, every other person working in the health sector was placed under the CONHESS structure. She added that prior to the emergence of the late president Yar’ Adua, his predecessor, President Olusegun Obasanjo had placed all Nigerian health workers under a unified Salary Scale but that NMA seriously kicked against it.

According to her, “In the late 2009, NMA started a campaign of calumny against members of JOHESU, that they were skipping, an allegation viewed as violation of government policy. They alleged that as medical doctors, they were treated unjustly in the health sector.” She stressed that despite the fact that NMA had remained the greatest beneficiary of government approved salary scale, with higher entry point and jumbo pay, it is bent in ensuring that members of JOHESU, who had moved from CONHESS 9 to CONHESS 11, are brought down to 11, thereby heating up the system. She explained that the accusation was faulty because, in the Scheme of Service for JOHESU members, there was nothing like Grade level 11.

“In fact, it is a misnomer to term the movement from Grade Level 10 to Grade Level 12 skipping,” she said. “This is not skipping, because there is no level 11 and what you have in the Scheme of Service is movement from Grade level 10 to 12. The Ministry of Health was seeing through the prism and binoculars of NMA.” She supported the recommendation subscribed by NMA that all JOHESU members who have moved from Grade Level 10 to Grade level 12 should be brought down by one grade level. According to her, in a circular dated January 11, 2010 , with reference number HCSF /EPO/ EIR/RR/B.63755/T1/77 ,the office of the Head of Service of the Federation stopped the movement of JOHESU members from Grade 10 to Grade level 12 About a year later, in a a similar circular dated February 10, 2011, with reference number HCSF/EPO/EIR/63755/ T1/149, called the movement of workers from Grade 10 to Grade Level 12 an unauthorized skipping. By June 2011, the health sector was already heated up with drum beats of war between the workers under the aegis of JOHESU and the Nigerian government represented by the Ministry of Health, she noted. She recalled also that as at June 28, 2010, in a meeting held at JUTH Guest House in Abuja, all chief medical directors and medical directors under the auspices of Committee of Chief Executives, Federal Tertiary Institutions in Nigeria, unanimously agreed and released a memo with the reference number CCEHTH/ SEC/V.1/86 on June 29,2010 addressed to all chief executives of Federal Health Institutions.

LEADERSHIP Sunday learnt that as a result of the crisis in the health sector, on August 9, 2011, the then minister of labour waded into the matter, but the Ministry of Health was not satisfied at the resolution, and the matter was later taken to the National Industrial Court for adjudication. After a legal battle between the Ministry of Health and JOHESU, the court ruled in favour of JOHESU in 2013, saying that government was wrong to have denied JOHESU members their right and that JOHESU members who were appointed consultants were wrongfully stopped as consultants. According to her, NMA hoodwinked the government into taking the wrong decision that was upturned by the court. “Suddenly, they started accusing government of favouring JOHESU members, and that they must skip, even though JOHESU members never skipped.

Now that the government is trying to muster the courage to do what is right, NMA/MDCAN has chosen to fight dirty,” she said. Experts in the sector are however of the view that should the federal government fail to meet the union’s demand, it will herald the 2018 phase of disruption and distraction that has characterised the nation’s health sector, forcing patients to patronise private health institutions. This persistent disruption of healthcare services that has become a tradition in the country’s health sector has been described by them as detrimental to human lives. They urged government to take proactive measures towards resolving the issues bedevilling to the sector rather than waiting for health workers to embark on industrial action before calling for discussion.